1- Pediatric Infectious Diseases Unit, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa 2- Pediatric Rheumatology Unit, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa
- 8th World Congress on Pediatric Infectious Diseases, Cape Town, South Africa, 19-22/11/2013
Background: Patients with juvenile idiopathic arthritis (JIA) with immunosuppressive treatment are at high risk of infections, some of them can be prevented by vaccination.
Aims: to evaluate the coverage of vaccines not included in the national vaccination programme (NVP) in those patients.
Methods: Retrospective study between 2006 and 2012. Varicella vaccine (VV), seasonal influenza (FluV), pneumococcal (PnV) and hepatitis A vaccine (HAV) were studied. Clinical processes were consulted and telephonic interviews were made to know the vaccination status.
Results: A total of 56/71 patients were included with a median age 10,48±5,05 years.
At diagnosis of the disease 82.1% of patients had NVP updated. There were vaccinated with other vaccines prior immunosuppressive therapy; corticosteroids, methotrexate, cyclosporine or biologic in 35 (62,5%) cases, two of these drugs in 15 (26,8%) and three or more in 6 (10,7%) cases.
62,5% had the FluV and 91,4% weren´t infected (p=0,03). 75.9% had the VV with one dose and three (14,3%) children (two with methotrexate and one with methotrexate and biologic) had varicella-zooster infection and required hospitalization (p=0,3). HAV was done in 44,6% of cases with no vaccinal failure. Eleven (19,6%) children were vaccinated with pneumococcal polysaccharide vaccine and 25 (44,6%) with pneumococcal conjugated vaccine and there was no case of invasive pneumococcal disease. For parents PnV (48/56) is the most important vaccine and FluV the least (51/56)
Conclusion: Our vaccination coverage is higher than the results founded in other similar international studies. Nevertheless vaccination protocols for this risk group should be done and implemented in daily clinical practice.
Keywords: Vaccines, Juvenile Idiopathic Arthritis, Immunosuppressive Treatment.